Nursing Case Study

Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.

Segre, A. R. (n.d.). Perinatal Depression: A Review of U.S. Legislation and Law. Retrieved from www.ncbi.nlm.nih.gov: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725295/

There was a case-controlled study that was performed using data from the pregnancy registry in Quebec. It showed the some doctors prescribed the woman the antidepressants to help with their depression and moods. There was one woman whom had a psychiatric disorder before the study took place. The antidepressant exposure was shown according to the months of the trimesters of use and what type of antidepressant they took. The infants born small for gestational age cases showed that the infants with a birth weight less to the tenth percentile following the Canadian charts. There were also, the relative risk took into factor. They were changed and shifted due to possible confounders.

There are many expecting mothers who suffer from serious mental illnesses like schizophrenia, bipolar disorder, or borderline personality disorder that requires they must take antipsychotic drugs to remain stable. There are different types of antipsychotics like typical and atypical. Typical antipsychotics are classified as the first generation of antipyschotics. The atypical antipsychotics, the second generation, are reported to be safer than the typical antipsychotics because they are the newer form of antipsychotic medication. Even though they are reported to be safer, they still have severe side effects on the individual consuming it, like tardive dyskinesia, which are uncontrollable movements of the mouth (McCauley et al., 2009). Some drugs can affect the fetus by transferring to the blood-brain barrier. The blood-brain barrier is a permeable barrier that allows some chemicals to pass through. It separates the circulating blood from the brain extracellular fluid in the central nervous system. The blood-brain barrier also transports molecules to the brain that are essential to function properly, like glucose and amino acids. Since capillary endothelial cells, which line the whole circulatory system, form the blood-brain barrier the medication could be transported to the fetus. From

Even though there are many studies that highlight the damaging effects of maternal alcohol use on a fetus in utero, there are a multitude of other substances that are used by pregnant mothers that have similar and even, in some cases, more extreme repercussions such as marijuana, heroin, and cocaine. When speaking about pregnancy and drug use, the most common drug that comes to mind is alcohol. During 12 years of schooling, most people are exposed, at one point or another, to the idea of Fetal Alcohol Syndrome and the detrimental effects of alcohol on a fetus in utero. The effects of maternal use of the aforementioned illicit drugs is less studied, partially because they are used less frequently. It is important, however, that as a population, we become more educated about these drugs and the potentially life threatening outcomes for babies in utero.

Substance abuse has been a worldwide problem at all levels of society since the beginning of time. Attention has been made toward the use of legal and illegal substance by pregnant women over the past several decades. Almost all drugs are known to cross the placenta and have some effect on the fetus. According to the American Academy of Pediatrics (2013) the first studies of the effect of substances consumed by a pregnant women to the developing fetus were identified in the 1960’s of prenatal tobacco use. These studies opened the door to further research and studies. The effects of Alcohol and opiate use have been studied since the 1970’s (Jones, Smith, 1973) and the effects of a variety of other drugs have been studied since 1979 and early 1980’s (Flinnegan, 1979).

According to the Centers for Disease Control and Prevention (CDC), birth defects results in one of every 33 babies. Teratogens account for 4 out of 5% of birth defects when chemical and drugs are in the system. The use of this or even infections can cause abnormal fetal development.

A child's development could be detoured by a misapplication of drugs. But depression and other conditions for which the drugs are prescribed may also have long-lasting deleterious effects on psychological and social development and even on brain structure and function. Both the risks of medicating and the risks of not medicating are likely to be greatest in the earliest years of life. (December 2005, 5)

One of the leading causes of mental retardation in the United States is fetal alcohol syndrome or FAS. Alcohol is the most commonly abused substance by pregnant women because it's legal and socially acceptable. A greater majority of young women are not aware of the complications that are involved with pregnancy. They see pregnancy as a way of bringing a life into the world but do not use the necessary safety measure in their dietary habits to prevent such damage or inhibitions of such a life. By continuing on their drinking binge throughout their pregnancy, they can cause an inexplicable damage to herself and the fetus she is carrying. In my opinion, any amount of alcohol combined with pregnancy can cause

In general, with every pregnancy there is a 3-5% chance of having a baby with a birth defect. If a woman takes Thalidomide during her first trimester of pregnancy, the chance of her giving birth to a child with a birth defect increased to a 20%+ chance and the fetal and infant death rate is estimated to be 40% or more due to severe birth defects. (Thalidomide Side Effects on Babies). A portion of the children who suffer from birth defects caused by Thalidomide also suffer from developmental disabilities such as autism. Thalidomide victim survivors still suffer from these symptoms today. How does Thalidomide create all of these issues? The answer is science. The placenta is a very important organ that develops in the womb during pregnancy. The placenta nourishes the baby through through the umbilical cord and gets rid of all waste. The placenta is the first line of defense for the baby. It is a barrier that many harmful substances do not have the ability to cross. Before a pharmaceutical is offered to

Fetal alcohol syndrome is caused when women during their pregnancy drink alcohol and cause developmental problems that can affect the fetus and infant for the rest of his or her life. Fetal alcohol syndrome can cause facial abnormalities, mental retardation, and a significant decrease in overall growth of the fetus.1 There are numerous studies about prevalence of fetal alcohol syndrome, and its effects on physical, neurological, and socioemotional functions of children. Many studies highlight that the risk of fetal alcohol increases by the amount of alcohol a woman drinks during her pregnancy. Many studies also support the idea that the more alcohol that is consumed during pregnancy, the greater the severity of the associated abnormalities that are found in the child. Because there is no cure for fetal alcohol syndrome, researchers have tried to achieve successful prevention plans by studying several options that could be implemented. The work that has been done to try and help children who have fetal alcohol syndrome is extensive but allows for further research.2

According to the author of this article, the syndrome is preventable only if the mother is able to change their behavior. This syndrome is said to cause disabilities in children especially the unborn children. Mothers found abusing drugs during pregnancy might be charged in court for risking the health of the unborn child. However, every person has the right to choose what to eat or drink during his or her pregnancy period but putting the health of the child in danger is out of question. As much as we want to protect these mothers, we also have to bear in mind the idea of making an innocent child suffer simply because you want to enjoy yourself without considering the risks you are exposing the child to. For instance, the syndrome may cause a series of disabilities in children, according to the author of this article states that one out of every woman in the United States of America uses alcohol or other drugs (Heinen,

Congenital heart diseases (CHDs) are the most prevalent of all birth defects and the leading cause of death in the first year of life, (1) with an annual prevalence ranging from six to twelve affected infants per 1,000 live births. (2)

Cause/Risk Factors Maternal use of drugs that then gets transported to the fetus where the fetus then becomes dependent of the drug and experiences withdrawals when drug is stopped at birth

The drugs that are used to treat neonates can be used multipurposely and often innovation drives creative uses of drugs to treat uncommon multifactorial complications (Allegaert & van den Anker, 2015). Knowledge of the drugs and their adverse effects is increasingly important when dosing a neonate. Due to their undeveloped body systems, in an event of an undesired reaction or drug error, the neonate would not be able to compensate and recover like the other patient groups may (Skene, Gupta, Flaherty, & Sherwood, 2012). Furthermore, this stresses the importance of being competent in drug calculations and being aware of the effect of medicines on this particularly vulnerable patient group (Stavroudis, Shore, Morlock, Hicks, Bundy, & Miller,